Living in Italy · A2 · Health

Family doctor and tessera sanitaria: how to register and what to say

by Alessio · teacher of Italian for foreigners, ITALS master’s in teaching Italian abroad (Ca’ Foscari University, Venice) and a master’s in teaching Italian as a second language (Giustino Fortunato University, Benevento)

In Italy you don’t go straight to a specialist. First the medico di base (family doctor); when tests or a specialist are needed, he or she writes an impegnativa, and only with that paper can you book.

4min read
10min practice
A2level

What you’ll find here

Where to register
How to choose a doctor
What an impegnativa is
For children

In short. Register with the ASL for your address, choose a family doctor from the list, and the tessera sanitaria arrives afterwards by post.

Bring your permit or receipt (or ID card if you’re an EU citizen), your codice fiscale, and proof of your address.

Step by step

Find your ASL
It’s split by address; look up the distretto office and its opening hours.
Register and pick a doctor
They give you a list at the counter. Doctors whose quota is full can’t be chosen.
Get the card
It comes by post; until then the paper the counter gives you works just as well.
Book an appointment
By phone or online. For the first visit bring the card and any medicines you take.
When tests are needed
The doctor writes an impegnativa; book at the CUP or online and pay the ticket if it applies.

This is where Italy differs from what you may be used to. Specialists and tests normally go through the family doctor first — there is no walk-in specialist system. The emergency room (pronto soccorso) is for genuine emergencies: for non-urgent problems the wait is long and you may be charged. Children don’t see the family doctor but a pediatra di libera scelta. And note that antibiotics are not sold over the counter: the pharmacy will ask for a prescription.

The back of the Italian health card, which is the European Health Insurance Card — The back of the same card is the European Health Insurance Card.

Words you’ll need

Italian	What it means
il medico di basechosen when you register	family doctor, the first port of call
la tessera sanitariaarrives by post	health card
l’impegnativawritten by the doctor	referral: the paper you need to book tests
la ricettaasked for at the pharmacy	prescription
il ticketpaid when booking	the share of the cost you pay yourself
l’ambulatoriothe doctor’s place	surgery, consulting room
il CUPby phone or at a counter	central booking service
l’esenzioneif you qualify	exemption from the ticket

Try it now

Fill in the gaps with the words from the table

Il medico mi ha dato l’ per gli esami del sangue.
In farmacia mi hanno chiesto la .
Ho pagato il alla cassa.
Ho prenotato la visita al .
Ho perso la sanitaria.
L’ del dottore è aperto la mattina.

EU citizens: EHIC is for visits, not for living here

The European Health Insurance Card from your own country covers you as a visitor: necessary treatment during a temporary stay. It is not a substitute for registering once you live here. If you work in Italy, registration with the national health service is compulsory and free, and it comes with a family doctor — which the EHIC does not give you. If you are not working, you either register voluntarily with an annual contribution or hold private cover; and remember this same health cover is one of the conditions the comune checks for iscrizione anagrafica. Retired and receiving a pension from another EU country? Ask your home institution for the S1 form: it transfers your cover to Italy at their expense.

What to say at the counter and at the doctor’s

Three sentences are enough: «Vorrei iscrivermi al servizio sanitario» (I’d like to register with the health service), «Devo scegliere il medico di base» (I need to choose a family doctor), «Ho bisogno dell’impegnativa per una visita» (I need a referral for an appointment). If you don’t follow, say «Può ripetere più lentamente, per favore?».

Where to check, without a middleman

Ministero della Salute ↗How the health service works and who must register.
Sistema Tessera Sanitaria ↗Card status and renewal.
Your Europe ↗EHIC, the S1 form and cover across the EU.

Common questions

Does registering with the health service cost anything?

For people with a work or family permit, and for EU citizens who work here, registration is compulsory and free. In other cases there may be an annual contribution: ask at the ASL counter.

The card hasn’t arrived. Can I still see a doctor?

Yes. The paper given to you when you register is valid until the card arrives.

Can I change family doctor?

Yes. Ask at the ASL counter, at any time, without giving a reason.